Perceptions and reflections of early graduates of the first emergency medicine residency program in Ethiopia: A qualitative study.

INTRODUCTION: A bi-institutional partnership between physicians at Addis Ababa University, Ethiopia and the University of Toronto, Canada led the development and implementation of a novel emergency medicine (EM) postgraduate training program at Addis Ababa University (AAU). Subsequently, the first three cohorts of trainees were invited to participate in the evaluation of the curricular components devised and delivered by Toronto EM physicians as part of the Toronto Addis Ababa Academic Collaboration in EM (TAAAC-EM). We sought to characterise the strengths and weaknesses of the curriculum to improve it for future trainee cohorts. METHODS: This curriculum assessment used semi-structured, in-depth individual interviews to evaluate components of the TAAAC-EM program curriculum. Interviews were conducted with a purposive sampling of graduates from the first three cohorts of the TAAAC-EM program. RESULTS: Twelve participants were interviewed. The following themes were identified; The TAAAC-EM program built a novel EM culture at AAU and shifted teaching from didactic to learner-centered strategies where teachers serve as role models; The curriculum content of the EM resident program, including didactic and practical sessions, was well received by the graduates interviewed; Challenges identified included lack of continuity in training, and difficulties transitioning to practice in a locally nascent field; Participants evaluated the TAAAC-EM program model as very positive overall, and supported replicating the model by expanding within Ethiopia and beyond. CONCLUSIONS: The challenges identified in the program, including lack of continuity of clinical teaching and meeting the local educational resource needs of new graduates, helped inform program adaptations and improvements. TAAAC-EM, currently in its eleventh year, is now focused on transitioning full teaching responsibilities to local faculty and continuing to support a positive EM teaching culture. We believe that this thriving partnership can serve as a model for future north-south and south-south collaborations in postgraduate medical education.

Maintaining a global health partnership during the COVID-19 pandemic: a road map from the Toronto Addis Ababa Academic Collaboration in Emergency Medicine.

The Toronto Addis Ababa Academic Collaboration in Emergency Medicine (TAAAC-EM) is an educational global health partnership established 10 years ago to support the growth of EM in Ethiopia. In-person global health partnership activities were disrupted by the COVID-19 pandemic. We describe our five-step process for transitioning our global health partnership to a virtual space. Each step was conducted in collaboration between the University of Toronto and Addis Ababa University EM physicians: (1) risk identification and needs assessment, (2) discussing mitigation strategies, (3) crafting and piloting an approach, (4) revising based on pilot results, 5) implementation with continuous evaluation and revision. Teaching was modified iteratively in response to feedback. Our experience shows that virtual teaching, while not a replacement for in-person engagement, can be a valuable tool both to supplement partnership activities when travel is not possible, and to enhance global health partnerships long term. This approach can also inform the transition of other forms of medical education to the virtual space.

RéSUMé: La Toronto Addis-Ababa collaboration universitaire en médecine d'urgence (TAAAC-EM) est un partenariat mondial en éducation à la santé établi il y a 10 ans pour soutenir la croissance de la médecine d'urgence en Éthiopie. Les activités du partenariat mondiale pour la santé en personne ont été perturbées par la pandémie de COVID-19. Nous décrivons notre processus en cinq étapes pour la transition de notre partenariat mondial pour la santé vers un espace virtuel. Chaque étape a été menée en collaboration entre les médecins d'urgences de l'Université de Toronto et de l'Université d'Addis-Ababa : 1) identification des risques et évaluation des besoins, 2) discussion des stratégies d'atténuation, 3) élaboration et pilotage d'une approche, 4) révision basée sur les résultats des projets pilotes, 5) mise en œuvre avec évaluation et révision continues. L'enseignement a été modifié de manière itérative en réponse aux commentaires. Notre expérience montre que l'enseignement virtuel, bien qu'il ne remplace pas l'engagement en personne, peut être un outil précieux à la fois pour compléter les activités de partenariat lorsque les déplacements ne sont pas possibles, et pour renforcer les partenariats mondiaux pour la santé à long terme. Cette approche peut également faire apprendre la transition d'autres formes de formation médicale vers l'espace virtuel.

Tackling challenges of global health electives: Resident experiences of a structured and supervised medicine elective within an existing global health partnership.

BACKGROUND: The Toronto-Addis Ababa Academic Collaboration in Emergency Medicine (TAAAC-EM) deploys teaching teams of Canadian EM faculty to Addis Ababa to deliver a longitudinal residency curriculum. Canadian trainees participate in these teams as a formally structured and supervised elective in global health (GH) and EM, which has been designed to enhance the strength of GH electives and address key challenges highlighted in the literature. METHODS: The purpose of this qualitative study was to identify, describe, and evaluate strengths and weaknesses of this elective in relation to its purposeful structure. Residents who completed the elective were invited to participate in face-to-face interviews to discuss their experiences. RESULTS: The findings show that the residents both chose this elective because of its purposefully designed features, and that these same features increased their enjoyment and the educational benefit of the elective. Supervised bedside teaching, relationships shared with Ethiopian residents, and the positive impact the experience had on their clinical practice in Canada were identified as the primary strengths. CONCLUSION: Purposeful and thoughtful design of global health electives can enhance the resident learning experience and mitigate challenges for trainees seeking global health training opportunities.